| NPI | 1790089084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP455972) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202205507) |
| Enumeration Date | 2011-01-01 |
| Last Update Date | 2025-02-15 |